New Coronavirus News from 22 Mar 2022

From a pandemic, scientific insights poised to impact more than just COVID-19 | Penn Today [Penn Today, 18 Mar2022]

by Katherine Unger Baillie

Pivoting to study SARS-CoV-2, many scientists on campus have launched new research projects that address the challenges of the pandemic but also prepare us to confront future challenges.

hen it emerged in 2019, the SARS-CoV-2 virus quickly revealed itself to be novel in many respects. Able to spread easily, causing a wide variety of symptoms and encircling the globe in a matter of weeks; this microscopic entity reshaped the world forever.

Looked at through a different lens, however, SARS-CoV-2 has a lot in common with pathogens that have come before. It takes advantage of gaps in its hosts’ immune response. It affects men and women differently. And SARS-CoV-2 can be neutralized by a range of vaccines and antiviral compounds that require specialized synthesis, manufacturing, and distribution.

Diving into each of these areas and many more, the pandemic prompted scientists at the University of Pennsylvania to launch new projects, sometimes pivoting from or finding new applications of their research programs. A silver lining of the pandemic may be the resulting discoveries, which stand to benefit humanity long after COVID-19—hopefully—recedes.

Prime among these is the mRNA therapeutic platform Drew Weissman, Katalin Karikó, and others developed, which is now poised to transform vaccination, gene therapy, and other biomedical horizons going forward. And the progress made in antiviral compound assays by researchers like Sara Cherry at the Perelman School of Medicine and Ronald Harty at the School of Veterinary Medicine may prove valuable in this or future pandemics. And these are just the tip of the iceberg.

Two years into this pandemic, Penn Today checked in with a selection of innovative researchers around the University whose work was transformed by the pandemic.
These are highlights of their pandemic pivots and the potential impact of their insights.

Viral mimic
Erica Korb, an assistant professor in the Perelman School of Medicine, studies neuroscience and epigenetics—on the surface, not subjects one might expect would overlap with COVID-19.

“But when the pandemic hit and we were all sent home, we were looking for ways to learn something new and keep busy,” she says.

Korb’s group specializes in histone modifications, changes to the proteins around which the genetic material chromatin wraps and twists. Histone modifications can change which portions of DNA are expressed. Other scientific groups had found that some viruses mimic histones to modify their hosts’ gene expression. With lab spaces temporarily closed early in the pandemic, Korb figured one way of “keeping busy” would be to lean into bioinformatics analyses, relying on computational methods. On a bit of a whim, she asked research assistant John Kee to run a computational analysis to see if any of the proteins in SARS-CoV-2 were a match for histone proteins.

“It was a simple thing—so simple nobody else thought to do it,” she says. “I was not expecting to find anything. But he came back to me the next day with a match for one of the most important sequences within the histone proteins. It was a better match than most previously established histone mimics.”

In fact, the virus appeared to mimic two different histone sites, both of which play significant roles in gene expression. The finding suggested that SARS-CoV-2 might be altering the host’s histones and gene expression, perhaps to ease its path to infection.

Partnering with colleagues including Shelley Berger, Susan Weiss, Edward Morrissey, Ben Garcia, and others, the Korb lab has been investigating this feature of the coronavirus ever since. They’re getting ready to publish their discoveries, including an indication that a viral protein has an overall repressive effect on gene expression. In future work, Korb hopes to dig into how this viral capability might relate to how SARS-CoV-2 evades immune defenses, perhaps even pointing to a therapeutic approach to block infection of this or other pathogens.

Gender differences
Early in the pandemic, Montserrat Anguera, an associate professor at the School of Veterinary Medicine, was intrigued by news reports about gender disparities in COVID-19 disease severity: Men tended to get sicker and had higher mortality rates. It sparked a question: Could X chromosome inactivation (XCI) and X-linked gene expression contribute to the sex bias?

Anguera’s lab studies the phenomenon, by which females with two copies of the X chromosome avoid duplicate gene expression by inhibiting expression from one of the Xs. This inhibition, however, is not always complete, and thus occasionally females may overexpress some X-chromosome-linked genes specifically from the inactive and silent X. Upon realizing that the gene for ACE2, the cellular receptor that SARS-CoV-2 uses to enter cells, is on the X-chromosome, Anguera launched a new path of research into sex differences in coronavirus infection, in collaboration with colleague Andrew Vaughan, whose expertise lies in lung cell regeneration.

“This is just a beautiful example of a collaboration that highlights the strengths of both PIs,” Anguera says. “We’re all about X inactivation and imbalanced gene expression. And Andy is all about these lung cells and how they work.”

Together they developed a mouse with a humanized version of the ACE2 gene to study hormonal and genetic contributions to the pathologies from SARS-Co-V2 infection. Using a novel method whereby they could quantify how much gene expression was occurring from each of the X chromosomes—the “active” as well as the “inactive” X—in lung cells, the researchers found ACE2 was escaping inactivation. And hundreds of other genes were escaping inactivation as well.

“Other people have looked at X-linked gene escape in spleen, brain, and ovary and only seen about 3-7% of expressed X-linked genes escape XCI,” says Anguera. “But with these progenitor lung cells, we’re seeing a ton of escape from the inactive X.”

Despite this escape, the researchers didn’t see more expression of these genes in female mice. They’re looking next to see if that holds true in human cells.

“We’re really excited to continue this deep dive into the genetics of sex differences, and now we have a model system to look at other cell types and how they respond to various viral infections including SARS-CoV-2.”

Viral detection
Despite being more than two years into the pandemic, it’s only relatively recently that effective home tests have been widely available. In the event of a future outbreak of disease, Ping Wang of the Perelman School of Medicine hopes to be way ahead of the game.

Point-of-care diagnostics was already a focus of Wang’s efforts prior to COVID-19. In 2018, she had developed a proof-of-concept test able to detect protein biomarkers—in that case, prostate specific antigen—with high sensitivity. The approach relied on quantifying the production of microbubbles, which formed during a reaction between hydrogen peroxide, platinum nanoparticles, and the target antigen.

When COVID arrived, it immediately struck Wang that her diagnostic could be used to test for SARS-CoV-2. The microbubbling assay fills what she sees as a gap in current testing: as sensitive as a PCR but with the rapidity of antigen tests.

From that realization, the work to adopt the test platform for SARS-CoV-2 went relatively quickly. But it also made Wang rethink how to market and package the test.

“Before the pandemic we were focusing a lot more using this in physicians’ offices and maybe pharmacy testing,” Wang says. “But I think the pandemic really opened up the need and acceptability of home testing.”

The low cost of the microbubbling assay—currently around $3 a test, which may be driven lower with mass production—could also help address inequitable health care access. “Seeing the pandemic expose health disparities really propelled us to think about how we can use our technology as a means to make diagnostics more accessible,” Wang says. She founded the start-up company Instanosis to commercialize the platform.

“We didn’t set out to develop this for COVID; we set out really to use it for many other things,” Wang says. “And post-pandemic, our goal is to extend its use. We think the technology is well-poised to be used for many other emerging pathogens or existing pathogens, even multiplex testing of respiratory pathogens and cardiology or neurology biomarkers—many different things that require high-sensitivity biomarker detection.”

Intricacies of immunology
COVID-19 has familiarized many with the importance of antibodies. Made by B cells, their production also relies on T cells, which make B cells better at churning out antibodies that are highly specific to a given pathogen. The type of T cell specialized in this task is known as a T follicular helper (TFH) cell, a centerpiece of Michela Locci’s lab at the Perelman School of Medicine.

Prior to 2020, Locci’s investigations had concentrated the basic biology of TFH cells. But their translational impact was also a focus. “We were already interested in the mRNA vaccine platform, and had been collaborating with [the Perelman School of Medicine’s] Norbert Pardi on it. Even before the pandemic started, I’d never seen a vaccine platform that effective.”

To learn more about the immunological response to mRNA vaccination, Locci wanted to study TFH cells and their role in antibody production in people, not just mice. To do so, she used a technique pioneered by a few other groups in which cells are extracted from the lymph node, where B cells and TFH cells interact. “You essentially poke the lymph node,” she says, “and some cells get stuck in the needle. The analysis of these cells gives you a window into what’s going on at different time points after vaccination.”

Taking this longitudinal approach to tracking development of an immune response “was one of the most exciting changes in the way we approach human immunology during the pandemic,” she says. In collaboration with the medical school’s Ali Naji and Vijay Bhoj, she and colleagues employed the technique in a study published last month in Cell. The research followed a group of kidney transplant recipients, whose immune systems were suppressed, and a group of healthy controls after they both received COVID-19 mRNA vaccines. They found severely impaired B cell and TFH cell responses in the immunosuppressed study participants.

“But in healthy individuals, two doses of mRNA vaccines elicited robust TFH responses, connected with the production of memory B cells and protective antibodies,” Locci says. This connection was not readily appreciable from the study of surrogate populations in blood, whereas it was evident in lymph nodes.

TFH cells play a role in establishing these long-lived B cell responses, and Locci hopes to continue digging into their role in SARS-CoV-2, such as following how these responses may change upon receiving vaccine boosters. But there are myriad applications in other disease and therapeutic avenues, which Locci will explore with a special emphasis on human biology in parallel to mouse biology. “At the end of the day, we particularly care about describing molecular pathways that exist in humans.”

Decentralizing vaccine manufacture
The development of multiple effective vaccines against the SARS-CoV-2 virus in a matter of months was an unprecedented scientific achievement. Yet the distribution of these medical game changers could only proceed as quickly as they could be manufactured in a limited number of facilities. Certain countries and regions waited months to get a supply, dependent on other nations to send them the products.

To Daeyeon Lee and colleagues in the School of Engineering and Applied Science, this obstacle in the supply chain is an engineering problem. In response to a call from the National Science Foundation (NSF) through the Emerging Frontiers in Research and Innovation Program, Lee and others developed a proposal to create a series of hubs where mRNA vaccines could be efficiently manufactured and distributed.

“The call for proposals was looking for ideas in the area of distributing manufacturing of chemicals,” says Lee, a professor and the Evan C. Thompson Term Chair for Excellence in Teaching in the Department of Chemical and Biomolecular Engineering. “When that call came, a bunch of us here at Penn and other institutions thought, Why don’t we apply that idea of distributed manufacturing to the mRNA vaccine?”

Prior to the pandemic, Lee had been working on a system involving simultaneous reaction and separation of different chemicals from reactions, which he could translate to how mRNA molecules are produced. “The idea is, How do we make manufacturing more robust so it can be done in more places?”

Lee, together with collaborator Kathleen Stebe from Penn Engineering and colleagues from the University of Oklahoma, the University of Colorado, and Drexel University, received the NSF grant. That support has led to other funding and opportunities, working in collaboration with Michael Mitchell and David Issadore from Penn Engineering, Penn Medicine’s Drew Weissman, and Infini Fluidics’ Sagar Yadvali to develop their on-demand manufacturing system.

Their vision is a network of research labs, each with the capacity to produce different mRNA therapeutics. The potential is great, as mRNA therapies are showing promise in addressing a host of diseases and disorders, from HIV infection to gene therapy.

“It’s like how the Singh Center, while relatively compact, nevertheless has the capability of fabricating sophisticated, high-tech devices,” Lee says. “We could have these small-scale pharmaceutical mRNA manufacturing centers that can be used during normal times for research purposes but switch over to pharmaceutical production as needed. It’s a way of democratizing the process.”

COVID digest: Europe is easing restrictions too 'brutally' — WHO [DW (English), 22 Mar 2022]

European countries such as Germany and Britain are now seeing a rise in COVID-19 cases from the more transmissible BA2 omicron variant. Meanwhile, Indonesia eased rules for tourists.

Several European countries, including Germany, France, Italy and Britain, have eased their COVID-19 restrictions too "brutally," the World Health Organization (WHO) said on Tuesday.

These nations are now also seeing a rise in coronavirus cases, most likely caused by the more transmissible BA2 omicron variant, the global health body added.

WHO Europe director Hans Kluge said he was "optimistic but vigilant" about coronavirus developments on the continent.

The virus is on the rise in 18 out of 53 countries in the WHO European region, Kluge told a press conference in Moldova.

"The countries where we see a particular increase are the United Kingdom, Ireland, Greece, Cyprus, France, Italy and Germany," he said.

He also said "those countries are lifting the restrictions brutally from too much to too few."
The number of new COVID-19 cases in Europe fell sharply after a peak at the end of January, but has been on the rise again since early March, according to the WHO database.

Within the last week, WHO reported more than 5.1 million new cases and 12,496 deaths for its European region.

Here are the latest major developments on coronavirus from around the world:

Asia
Indonesia has expanded its quarantine-free travel for tourists to include the entire country, following a successful trial run on the resort island of Bali, the Tourism Ministry said on Tuesday.

The decision comes as a result of compliance with strict health protocols and a low rate of positive COVID-19 tests, Tourism Minister Sandiaga Uno said in a statement.

International visitors now only have to produce a negative PCR test, Uno said.

China has called a lockdown on an industrial city of 9 million people late on Monday as the country registered more than 4,000 virus cases on Tuesday.

Shenyang, home to many factories, including BMW's, reported 47 new cases on Tuesday as the city locked down. Residents are barred from leaving their homes without showing a 48-hour negative test result.

In recent weeks, China's "zero-COVID" strategy had been battling a surging omicron wave that forced the government to impose localized lockdowns and increase mass testing.

But authorities have been concerned about the risk that persistent lockdowns could pose to the country's economic growth.

Last week, President Xi Jinping stressed the need to "minimize the impact" of the pandemic on China's economy, but also urged officials to stick to the current zero-COVID approach

Europe
Germany's President Frank Walter Steinmeier and his wife, Elke, have tested positive for COVID-19, the head of state's office said on Tuesday.

Both have mild symptoms and immediately went into self-isolation, the office added.

The news comes after the country's infection rates continues to be persistently high in recent weeks and German states have delayed the easing of restrictions.

Norway's King Harald V also tested positive for the coronavirus on Tuesday and has mild symptoms,

royal officials said.

His son and heir to the throne, Crown Prince Haakon, will take over duties while the 85-year-old Harald takes a break for a few days, the royal household said in a brief statement.

Americas
More than two-thirds of all COVID-19 cases in the United States in the week ending March 19 have been identified as the BA2 omicron subvariant, the US Centers for Disease Control and Prevention (CDC) estimated on Tuesday.

COVID-19 infections in the US have slowed sharply since reaching record levels in January, but a coronavirus resurgence in parts of Asia and Europe because of the spread of the omicron variant has raised concerns.

Some experts have warned that higher levels of the omicron subvariant, combined with the ending of most national coronavirus restrictions, could lead to a new wave.

Most of the country's infection rates remain low and, as of March 19, the seven-day average of COVID-19 cases was 27,747, a decrease of nearly 18% from a week earlier.

Elsewhere, former Secretary of State and US presidential candidate Hillary Clinton has tested positive for COVID-19 after suffering from "mil" symptoms.

Clinton said on Twitter she was "feeling fine" and that former President Bill Clinton had tested negative and was quarantining until their household was "fully cleared."

New Coronavirus News from 23 Mar 2022

This is no time to stop tracking COVID-19 [Nature.com, 23 Mar 2022]

To live with the coronavirus, we cannot be blind to its movements.

From the way political leaders in many high-income nations are talking and acting, it would be easy to think that the COVID-19 pandemic is no longer worth keeping track of.

The pandemic might have taken upwards of 18 million lives, disabled many more than that and gut-punched the global economy, yet surveillance and reporting of the virus’s movements are starting to slow just at a time when a highly infectious subvariant of Omicron, BA.2, is spilling out across the world and case rates and hospitalizations are creeping back up.

These cutbacks are not based on evidence. They are political, and they could have disastrous consequences for the world. Maria Van Kerkhove, technical lead for COVID-19 at the World Health Organization (WHO), says it’s crucial that “the systems that have been put in place for surveillance, for testing, for sequencing right now be reinforced, that they are not taken apart”.

Around the world, the frequency of national reporting has slipped below five days a week for the first time since the early months of the pandemic, according to the publishers of the website Our World in Data. In the United States, the Centers for Disease Control and Prevention (CDC) is still reporting nationwide data, but there’s less real-time reporting of death and infection figures at the local level. All but eight states have scaled back to reporting data five or fewer days per week. Florida announced last week that it will now be reporting only fortnightly.

The UK government’s COVID-19 tracking dashboard, one of the world’s most comprehensive, is stopping its weekend updates of infections, mortality, hospitalizations and vaccinations, lumping Saturday and Sunday figures into Monday’s. Prime Minister Boris Johnson says this is part of plans to “live with COVID”.

The downward trend in reporting is subtle, but it mirrors other signs of complacency about COVID-19. The United Kingdom, for example, will no longer provide diagnostic tests free of cost. Several of its data-collection programmes are also ending. REACT-1, a long-running random-testing study, will lose its government funding at the end of this month. And ZOE, a mobile app that residents can use to log their COVID-19 symptoms, has lost its public funding, too. Both have been invaluable to research and policy.

The United States and United Kingdom aren’t alone. In many countries, political sentiments are shifting towards adopting a ‘new normal’. Of course, national budgets are being stretched thin as governments look to increase public expenditure on subsidizing fuel and food as the world plunges from dealing with the pandemic to tackling the global impacts of war in Ukraine. But scaling back virus surveillance at this time is short-sighted. It’s like stopping a course of antibiotics at the first sign of symptoms easing: it increases the risk that the infection will roar back. A study published last week says the next variant could well be more dangerous than those circulating now (P. V. Markov et al. Nature Rev. Microbiol. https://doi.org/hk3q; 2022).

COVID’s true death toll: much higher than official records

Public-health decisions need to be informed by the best available data. Cutting the ability to track and respond to the virus while most of the world remains unvaccinated makes these decisions less reliable. It will also reduce people’s ability make decisions about their own safety.

This is all the more infuriating given that roll-backs of public-health interventions have often come with messages that people should now decide for themselves what measures to take. The CDC, for example, recommends that people at risk of serious complications from COVID-19 “talk to their healthcare provider” about whether they should wear a mask or respirator during “medium” community transmission levels — just when data on transmission are becoming less accessible.

Researchers have worked hard to make disparate sources of data about the pandemic available to the public through several celebrated dashboards. Tools such as the WHO Coronavirus (COVID-19) Dashboard, Our World in Data and Johns Hopkins University’s COVID-19 Dashboard have empowered governments, businesses and individuals to use the best available evidence to make decisions. By reducing the data streams that power these dashboards, governments are shutting their eyes to the danger. If this trend continues, the new normal is going to look a lot like the false comfort of ignorance.

Nature 603, 550 (2022)
doi: https://doi.org/10.1038/d41586-022-00788-y

Frustrations mount in Shenyang as China locks down another city of nine million people due to COVID-19 [ABC News, 23 Mar 2022]

China has locked down an industrial city of 9 million people overnight and reported more than 4,000 new cases of the COVID-19 virus, as the nation's "zero-COVID" strategy was implemented to halt an Omicron outbreak.
Key points:
• China reported its first two COVID-19 deaths in more than a year
• Authorities warned of the risk posed to economic growth by persistent lockdowns
• Mass lockdowns and mandatory testing have led to growing frustrations throughout
China
Health authorities reported 4,770 new infections across the nation, the bulk in the north-eastern province of Jilin, as the city of Shenyang in neighbouring Liaoning province was ordered to lock down late on Monday.

In Jilin, another city of nine million — Changchun — was ordered into lockdown earlier this month.

China has moved fast in recent weeks to snuff out virus clusters with a pick-and-mix of hyper-local lockdowns, mass testing and citywide closures.

It reported two COVID-19 deaths on Saturday, its first in more than a year.

Authorities warned of the risk posed to growth by persistent lockdowns as the country strives to balance the health crisis with the needs of the world's second-biggest economy.

Shenyang — an industrial base home to factories, including car-maker BMW — reported 47 new cases on Tuesday as authorities put all housing compounds under "closed management" and barred residents from leaving without a 48-hour negative test result.

'Minimise the impact'
New COVID-19 outbreaks have hit large economic centres including Shanghai, Shenzhen and Beijing.(AP)

Last week, Chinese President Xi Jinping stressed the need to "minimise the impact" of the pandemic on China's economy, but also urged officials to "stick to" the current zero-COVID approach.

But Beijing's virus playbook has been stretched to the limit by the latest Omicron surge, which has forced authorities to free up hospital beds from mild-symptom patients.

China's elderly people are still unvaccinated
China has recorded its worst COVID outbreak in two years, but millions of people aged 60 years and above are not vaccinated.

Some cities, such as Shanghai, have avoided a full lockdown and, instead, imposed a web of individual building lockdowns, even as new daily asymptomatic infections there spiral into the hundreds.

Jilin provincial officials announced on Monday that the first 10,000 doses of Pfizer's oral COVID-19 drug arrived on Sunday, marking the first time Paxlovid has been used in China.

The province last week imposed strict travel curbs, banning locals from leaving their cities and counties, while several cities have already confined residents at home.

On Monday, the southern tech powerhouse city of Shenzhen announced it would lift its week-long lockdown "in an orderly manner", after having partially eased measures on Friday to minimise the impact of virus shutdowns on factories and ports.

Health officials last week revealed only around half of Chinese older than 80 years have been double-vaccinated, as the spectre of Hong Kong's dire COVID-19 mortality rates — mainly among the unvaccinated elderly — hangs over Beijing's decision-making.

'Refuse quarantine'
Mass lockdowns and repeated mandatory testing have led to growing frustrations throughout China.

In footage shared on social media last week, a crowd of people in Shenyang banged against the windows of a clothing market as they shouted in frustration at the announcement of yet another round of COVID-19 tests.

Why Chinese citizens support Beijing's COVID-zero policy China now has fewer officially reported COVID-19 cases than Australia, and many Chinese citizens believe maintaining "COVID zero" by keeping its international borders closed is the only way to protect them — even if it means they continue to be separated from family.

"Refuse quarantine!" said one.

"Many people have awoken to the truth," said another.

"It's actually over," said a netizen posting on WeChat under the username "Jasmine Tea".
"The common cold is more serious than this! The testing agencies want this to go on. The vaccine companies want to inoculate forever."

Residents have also complained about the arbitrary nature of the rules, as well as the unchecked power of the neighbourhood residential committees responsible for enforcing them.

In Beijing, one family said their residential committee was about to install a monitoring device on their apartment door to ensure they complied with an order to stay home for two weeks.
The order came after a family member entered a supermarket that had been visited two days before by a confirmed COVID-19 case.

In Shanghai, residents were also bewildered by the uneven testing standards and lockdown thresholds imposed by apartment blocks and compounds across the city.

However, China's policies have caused more than mere inconvenience, with netizens increasingly willing to discuss how lockdowns have led to tragedy.

A widely shared post on Weibo last week reported that a patient undergoing chemotherapy at the Shanghai Cancer Hospital died while locked down in her lodgings next to the hospital.
In posts since deleted, bereaved citizens also shared stories about the death of loved ones caused by COVID-related disruptions.

"My dad died of a stroke at the end of last year," said one, posting under the name MaDDNa.

"There was some hope of treatment. Unfortunately, we had to wait for a nucleic acid test report and missed the best treatment time."

S. Korea’s daily COVID-19 cases rebound to nearly 500,000 [The Korea Herald, 23 Mar 2022]

By Shim Woo-hyun

South Korea added nearly 500,000 daily COVID-19 cases during the 24 hours of Tuesday, pushing the country’s accumulated figure over the 10 million mark.

According to the Korea Disease Control and Prevention Agency, the country’s daily COVID-19 cases reached 490,881, the second-highest daily tally, after 621,205 cases reported Thursday last week.

The country’s accumulated caseload surpassed 10,427,247, which accounts for around 20 percent of the country’s total population of 51 million.

South Korea has suffered more than 9.5 million new cases this year alone, a stark contrast with the 630,821 cases reported between 2020 and 2021.

The government previously estimated that the country will see decreases in the number of daily COVID-10 cases starting Wednesday.

However, the “stealth omicron” variant, BA.2, which is thought to be 30 percent more transmissible than the original omicron variant, has been spreading rapidly, prolonging the omicron wave.

Prime Minister Kim Boo-kyum pointed out that patients infected with the stealth omicron variant accounted for some 40 percent of the total COVID-19 patients, during a COVID-19 response meeting Wednesday.

But Kim stressed that the country can still manage the spread of the stealth omicron variant, with saying that the stealth subvariant of the omicron strain will not correlate to sudden spikes in hospitalizations or deaths.

Kim added the government will continue to focus on minimizing the number of COVID-19 related deaths and critically ill patients, which are expected to continue to remain high in the following one or two weeks.

On Tuesday, the country added 291 COVID-19 deaths, down from the previous day’s 384. The death toll from COVID-19 reached 13,432, and the fatality rate stood at 0.13 percent.

The number of critically ill patients has remained over 1,000 for 16 days straight. As of midnight Tuesday, the severe cases reached 1,084 on Tuesday, down 20 from the previous day.

As the number of severe cases and COVID-19 deaths remain high, the government is speeding up the procurement of antiviral medicines for COVID-19.

South Korea said earlier that it will introduce Merck’s oral antiviral medicine Lagevrio for 100,000 patients this week, amid the ongoing shortage of antiviral treatments.

The country currently has around 70,000 doses of Pfizer’s oral COVID-19 treatment Paxlovid, but the treatment is quickly running out as the number of severe cases remained higher than expected.

Jung Ki-suck, director of Hallym University Sacred Heart Hospital and the head of a COVID-19 response team within the presidential transition committee, also emphasized the importance of procuring antiviral treatments from the US or European countries.

Jung also mentioned that the country should look into possibilities of local development of a biosimilar of an antiviral medicine for COVID-19.

Meanwhile, South Korea is expected to discard hundreds of thousands of doses of COVID-19 vaccines by the end of this month, due to lower-than-expected demand.

UK Covid cases breach 100,000 again as daily figure rises 12% in a week [Daily Mail, 23 Mar 2022]

By LUKE ANDREWS and EMILY CRAIG

Britain's daily Covid cases breached 100,000 for the second time this month today after rising 12 per cent in a week, while hospitalisations and deaths also ticked upwards.

Government dashboard statistics show 102,483 new infections were logged over the last 24 hours, compared to the 91,345 last Wednesday.

It is the second time in just eight days that daily cases have risen above the six-figure threshold, after the Omicron wave collapsed in late January.

Another 194 Covid fatalities were reported today, up 27 per cent on a week ago.
Hospitalisations also rose 30 per cent in a week, according to the latest UK-wide data for March 19, with 2,011 new admissions.

The rising statistics have been attributed to the loosening of restrictions across the UK and the rise of the more infectious BA.2 Omicron subvariant.

The extremely transmissible sub-strain is still causing milder illness than previous variants, however, and around half of patients in hospital with Covid currently are not primarily ill with the virus, separate data suggests.

Meanwhile, in a downbeat assessment of how the next phase of the pandemic will pan out, Professor Chris Whitty warned today that there was a 'high chance' a Covid variant more severe than Omicron and BA.2 will emerge in the next two years.

Speaking at the Local Government Association's public health conference, Sir Chris said there was still a 'long way to go' because the virus will continue to 'throw surprises'. He also insisted the virus — which now poses a similar threat as flu — will be with us 'for the rest of our lives'.

The emergence of a more dangerous strain could 'significantly change our balance of risk', Sir Chris added in his speech, on the second anniversary of the historic coronavirus lockdown.

Some experts believe there is a high chance that a new Covid variant could be more severe than Omicron because the strain came from a different part of the virus's lineage and there is no guarantee the next strain will evolve directly from Omicron.

But other experts have repeatedly insisted the darkest days of the pandemic have been consigned to history, as the virus will mutate into a cold-causing pathogen over time.

UK Health Security Agency (UKHSA) data showed daily Covid cases ticked up in England (up 34 per cent) and Scotland (up 16 per cent) compared to the same time last week.

They remained level in Wales (no change compared to last week), but fell in Northern Ireland (down five per cent).

About 770,000 swabs were carried out yesterday, similar to the same time last week, in another sign the country's outbreak is still growing.

The surging wave of infections has been blamed on BA.2, thought to be significantly more infectious than its parent Omicron strain. Although ministers say an uptick in cases was to be expected once the final Covid restrictions had been lifted.

Some experts have suggested the wave will peak before the end of this month.

Omicron burst onto the scene in November, with infection rates hitting pandemic highs and experts estimating one in 15 people in England were infected at the winter peak.

Grim modelling by SAGE had warned of up to 6,000 deaths a day, prompting the Government's own advisers to call for stringent measures. Some doom-mongering scientists even wanted a circuit-breaker.

But Boris Johnson held his nerve and stuck to the 'Plan B' measures already in place, which saw the return of work from home, face masks in public places and a ramping up of the booster programme.

Sky-high immunity rates and the variant's milder nature blunted the impact of the virus, with Covid deaths peaking at 300 a day — similar to levels seen in a bad flu winter and a fraction of rates seen during the first and second waves. NHS hospitals were never overwhelmed and intensive care admissions barely budged.

Asked at the conference today when the Covid pandemic will truly shift to an endemic stage, Sir Chris said it 'will become less dominant steadily'.

He said the UK would likely be hit by seasonal waves for the next 'two or three years' that will be 'interspersed' by new variants that could occur between peaks.

Dismissing the idea that Covid has become endemic, he said it is incorrect to assume the virus has reached a 'stable state' around the globe, despite restrictions easing for Britons.

Sir Chris added: 'The UK has chosen a particular path and we have high immunity due to vaccination rates in children, the elderly and some immunity due to infection as well.

'But others have chosen perfectly sensible paths but they're going to play out differently. So I think we need to be aware there's a long way to go with this and it'll also throw surprises as it has.

'And there's a high chance that we will all be discussing, and I will be discussing with my colleagues, a new variant at some point in the next two years that actually significantly changes our balance of risk.'

Sir Chris told the virtual conference: 'We could well end up with a new variant that produces worse problems than we've got with Omicron and the Omicron problems are by no means trivial.'

Gloomy SAGE advisers warned of a 'realistic possibility' that a more lethal variant could emerge that kills one in three people, in line with earlier coronaviruses such as MERS.

And Professor Devi Sridhar, a global public health expert at the University of Edinburgh, told the conference that she does not believe the virus will 'fade into the background' anytime soon.

It comes as the UK's daily Covid cases yesterday dropped for the first time in three weeks.
Government dashboard data showed 94,524 infections were recorded, down 14 per cent on a week ago.

But 'technical issues' meant Scotland reported four days' worth of cases last Tuesday, which artificially inflated the UK-wide daily tally.

Covid deaths rose by a quarter compared to a week ago, however, with 250 recorded.

And hospital admissions also ticked upwards 17 per cent in a week, after 1,879 admissions were logged on March 18 — the latest date UK-wide data is available for.

Experts have blamed the uptick on BA.2, which is now dominant in the country. But the strain is not thought to be any more severe than the original Omicron variant.

Cases have also been spiralling for a fortnight on the back of England's 'Freedom Day', which the Health Secretary Sajid Javid insisted was 'expected'.

Speaking about the current Covid situation, Sir Chris said the BA.2 Omicron variant is a 'large part' of the current high rates that are rising 'in virtually all parts of England'.

He said the strain, thought to be as contagious as chickenpox, is not translating into surges in deaths or intensive care admissions — but 'that doesn't mean that it is having no impact at all'.

There are 'significant numbers' in hospital and admissions will 'rise for at least the next two weeks', which Sir Chris warned would pile pressure on the NHS.

He added that the health system was already under 'significant' strain as it juggles an uptick in Covid patients alongside the national effort to tackle the record backlog of patients waiting for routine operations.

Sir Chris noted that the ratio of infections turning into hospitalisations and deaths has consistently decreased due to increasing immunity from vaccines and infection, as well as improvements in medical care.

He said: 'There has been a de-risking to some degree of Covid over time. But de-risking is not the same as no risk and there is still significant risk.'

Top 10 world news: Covid rampage in China, S.Korea, Belarus to join Russia-Ukraine war, and more [WION, 23 Mar 2022]

As coronavirus continues its rampage, the World Health Organization (WHO) has attributed the rise in Europe's cases to the hasty and 'brutal' lifting of Covid restrictions. In China's capital, people are panic buying as the country's biggest outbreak brings with it the threat of lockdowns. In South Korea, the cases have reached 10 million.

South Korea COVID-19: Cases hit 10m, leaving crematoriums and funeral homes struggling to cope [Sky News, 23 Mar 2022]

By Russell Hope

Nearly 500,000 cases were reported on Tuesday, the second highest daily tally since the pandemic began. Funeral homes across the country have been ordered to expand their facilities.

More than 10 million people in South Korea have contracted coronavirus as a surge in the highly infectious Omicron variant has caused a record wave of infections, officials have said.
The number of dead has almost doubled since early February, leaving funeral homes and crematoriums struggling to cope.

The Korean Disease Control Agency (KDCA) reported 490,881 cases for Tuesday, the second highest daily tally after it peaked at 621,205 on 16 March.

Image:Digital screens showing precautions against the coronavirus in a subway train in in Seoul
In all 291 people were reported dead after contracting the illness over the last 24 hours, after daily deaths peaked at 429 last Friday.

At least 13,432 people have died since the pandemic began, from a total of 10,427,247 cases, the KDCA said.

Nearly a fifth of the country's population of 52 million has now had or is battling the disease, according to the latest figures.

South Korea reacted to the initial outbreak with a strict regime of tracing and quarantine, but with 87% of its population fully vaccinated, they have been scrapped by Seoul, along with social distancing curbs.

More bodies to be burned
Ministers have told the country's 60 crematoriums to open longer and burn seven bodies a day, up from five.

The 1,136 funeral homes, which can hold around 8,700 bodies, have been instructed to expand their facilities.

Health ministry official Son Young-rae said: "Crematories' capacity is increasing, but there are still regional differences."

The number of bodies that can be disposed of daily was raised to 1,400 from 1,000 last week, but there is a big backlog and in the densely populated greater Seoul area, long waits are common, Mr Son said.

The percentage of intensive care beds occupied rose to around 64% on Wednesday, up from 59% two weeks earlier.

COVID treatment pills
Merck & Co's COVID-19 treatment pill, Lagevrio, has been given emergency approval by South Korea's drug safety agency, as authorities move to combat the surge.

Pfizer's highly effective Paxlovid is already being used.

Health ministry official Park Hyang said on Wednesday: "The medical system is under substantial pressure, though it is still operated within a manageable range.

"We would focus more on high risk groups going forward, and make constant checks to ensure that there is no blind spot."

Opinion | If the world doesn't act, North Korea could become a breeding ground for dangerous covid variants [The Washington Post, 23 Mar 2022]

By Victor Cha, Katrin Fraser Katz and Stephen Morrison

Victor Cha is a professor at Georgetown University and senior vice president at the Center for Strategic and International Studies. Katrin Fraser Katz is a fellow with the Korea Chair at CSIS. J. Stephen Morrison is senior vice president and director of the Global Health Policy Center at CSIS.

North Korea’s nuclear-tipped missiles are not the only threat from the rogue nation that
demands the world’s attention. It is also at high risk of a runaway coronavirus outbreak, which could create a breeding ground for new, dangerous variants.

For two years, North Korea has imposed a “zero covid” policy. Pyongyang claims that this has been successful in keeping the country covid-free, but it has also cut off critical food and medical supplies, resulting in severe shortages. It has also left its population of approximately 25 million people both unvaccinated (despite multiple offers from Covax, the United Nations-backed global vaccine initiative) and probably with minuscule immunity from prior infections.

An expert panel convened by the Center for Strategic and International Studies found this month that this has made North Korea uniquely susceptible to a sudden outbreak of the covid-19 omicron variant that could kill more than 100,000 people. That would obviously be terrible from a humanitarian perspective, but it could also worsen the pandemic by giving the coronavirus more chances to evolve and potentially even escape immunity provided by vaccines or previous infection.

What to do about this risk? The Biden administration has hit a rut in addressing North Korea’s nuclear threat, with Pyongyang expressing no interest in talking. But a stalemate in the denuclearization sphere should not stop the United States from considering multilateral pathways to prevent a covid-19 crisis in North Korea.

One possible initiative that might persuade North Korea to reconsider its previous rejection of coronavirus vaccines would be a high-volume offer from Covax of enough mRNA doses to inoculate more than 80 percent of North Korea’s population, combined with enhanced testing and eventual access to antivirals. This would probably get North Korea’s attention, especially as it witnesses the surge in hospitalizations and deaths in Hong Kong. In private settings, North Korean officials have indicated their preference for mRNA vaccines over the less effective Chinese Sinovac and AstraZeneca vaccines that Covax has previously offered. Such a program would also allow North Korean leaders to partially reopen their economy.

Such an initiative is feasible. Global supplies of mRNA vaccines and tests are ample, and North Korea has the infrastructure and experience necessary to implement mass vaccination campaigns at a relatively rapid pace (before the pandemic, more than 95 percent of North Korea’s population received shots for diseases such as measles and polio). Additional cold-chain investments for a national mRNA vaccine campaign would not be prohibitively costly.

Such a campaign would have to overcome some systematic hurdles. Although there is no “anti-vax” culture in North Korea, its leaders would have to actively engage with residents to explain why the nation is now turning to vaccines after saying that there was no need for them. North Korea would also probably push back against monitoring requirements or raise concerns that vaccine donations would be tied to requests, such as denuclearization.

North Korea’s approach to negotiation also creates challenges. Its leaders often do not reveal what they want, and they also “forum shop” among various aid organizations to seek the best possible deal. China, which adheres fiercely to its “zero covid” approach, may object to efforts to move North Korea beyond such an approach.

These problems have workarounds. Monitoring could be recast as “technical support,” with UNICEF or the World Health Organization serving as the main interlocutors with Pyongyang (not unlike their current role in sustaining health programs in Afghanistan). Washington could endorse a multilateral humanitarian approach, as it has previously, that emphasizes its de-linking of aid from strategic interests such as denuclearization.

This may seem a strange proposal coming on the heels of yet another series of North Korean missile tests. But the humanitarian crises already unfolding in North Korea, which would be exacerbated in the event of a covid-19 outbreak, can and should be addressed with urgency and separately from the nuclear issue. The inauguration of South Korean President-elect Yoon Suk-yeol in May could provide an opening for this type of initiative. While Yoon has advocated a tough line on denuclearization, he has not opposed humanitarian engagement with North Korea.

It is certainly possible that a mass-vaccination initiative could create better atmospherics between Washington and Pyongyang and dissuade North Korea from starting a new cycle of provocations. But even if it did not, it would still be a worthy endeavor. Protecting innocent North Koreans from a deadly disease is not only the right thing to do — it’s also in the interest of countries everywhere that seek to end the pandemic.